Glaucoma

Glaucoma is a disease of the optic nerve which is the nerve connecting the eye to the visual centers in the brain.  While there are different types of glaucoma with varying characteristics, it is usually diagnosed when someone has a combination of high eye pressure and damage to the optic nerve.  It can lead to loss of peripheral vision, and if untreated, blindness.

Not necessarily.  There are some patients who just have high pressure and no nerve damage.  In this case, the diagnosis is ocular hypertension and typically does not need treatment.  There are also some patients who have nerve damage despite having normal eye pressure.  In this case, the diagnosis is normal or low pressure glaucoma and does require treatment.

Glaucoma is a tricky disease because there are no obvious symptoms.  It typically does not cause pain, redness or a noticeable change in the vision.  However, patients with glaucoma develop changes in the appearance of the optic nerve and blind spots in the peripheral vision.

To properly evaluate a patient for glaucoma, a number of things can be checked.  This includes the eye pressure and a dilated eye exam to check the appearance of the optic nerve.  The optic nerve can also be evaluated with a special scan called an OCT.  A test of the peripheral vision called a visual field test is also recommended.

Yes.  There are two main types: open angle and closed angle.  The angle refers to the width of the opening to the drainage system of the eye. 

Open angle is the most common form in the United States.  It is slowly progressive and silent with regard to symptoms. 

Closed angle typically presents more dramatically with a sudden and severe increase in eye pressure accompanied by redness, pain, seeing halos, and blurred vision.  Closed angle is an eye emergency and requires immediate treatment.

Controlling the eye pressure is the goal of glaucoma treatment.  Medication in the form of eye drops is the first line of treatment.  Patients with more challenging cases may require laser.  Surgery is usually reserved for the most difficult cases which are resistant to the other forms of treatment.